After two or more prior cesareans
Rupture risk is similar. Other risks are not.
In a study comparing women with multiple prior cesareans to those with one, uterine rupture during a trial of labor occurred in 9 of 975 women with multiple prior cesareans (0.9%) and 115 of 16,915 women with one (0.7%). That difference was not statistically significant.
Other outcomes did differ. Hysterectomy occurred in 0.6% versus 0.2%, and transfusion in 3.2% versus 1.6%. Overall serious maternal complications were higher with a trial of labor after multiple cesareans than with a scheduled repeat.
Where this comes from:
286. Landon MB, Spong CY, Thom E, Hauth JC, Bloom SL, Varner MW, et al. Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery. Obstet Gynecol. 2006;108(1):12-20.
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